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Background: Emerging research suggests morning cannabis use may be associated with using more cannabis and experiencing more cannabis-related consequences. This paper examined whether months when young adults reported morning cannabis use (use between 6:00AM and 12:00PM) were associated with cannabis use frequency, negative cannabis-related consequences, and changes in cannabis use disorder (CUD) symptoms., Methods: Participants were 778 young adults (M age =21.11 years, 58.5% female) enrolled in a longitudinal study on substance use and social role transitions. Eligible participants were 18-23 years old at screening and reported past-year alcohol use. Participants completed a baseline survey, 24 consecutive monthly surveys, and a follow-up survey 30 months after baseline. Aims were tested using multilevel models and multiple regression., Results: Analyses were limited to cannabis use months (N=4719; 28.9% of sampled months) and participants who reported cannabis use at least once (N=542; 69.7% of all participants). Morning use was reported in 12.3% of cannabis use months and at least once by 23.6% of participants who reported using cannabis. Relative to non-morning use months, morning use months were associated with greater cannabis use frequency and more negative consequences. However, the association between morning use and negative consequences was not statistically significant after controlling for cannabis use frequency. The percentage of cannabis use months with morning use was positively associated with increased CUD symptoms at the 30-month follow-up, relative to baseline., Conclusions: Morning cannabis use may be a useful marker of high-risk cannabis use and may contribute to the maintenance and worsening of CUD over time., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Morning cannabis use is associated with heavier, frequent cannabis use and more cannabis-related negative consequences, yet little empirical research has examined its predictors. Using 24 months of longitudinal data, the present study tested demographic, psychosocial, and behavioral predictors of morning cannabis use among young adults at the monthly- and person-levels. Young adults (N = 778) were part of a larger study on substance use and social role transitions; participants completed a baseline survey and up to 24 consecutive monthly surveys. Hypotheses were tested using logistic multilevel models to estimate odds ratios for any vs. no morning use in a given month. At the monthly level, social anxiety motives and cannabis use frequency on a given month were positively associated with morning cannabis use. At the person level, typical coping motives, average cannabis use frequency, and male sex were positively associated with morning cannabis use. Findings advance our understanding of individual and psychosocial predictors of morning cannabis use among young adults. Notably, social anxiety motives may represent a malleable target for intervention efforts that could reduce risky use patterns associated with morning use. Such efforts may be especially prudent for young men, as our findings indicated morning cannabis use probabilities were much higher for men than women., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: Alcohol- and cannabis-impaired driving behaviors remain a public health concern especially among young adults (i.e., ages 18-25). Limited updates to prevention efforts for these behaviors may be due, in part, to limited understanding of malleable psychosocial predictors. The current study assessed associations between perceived injunctive norms (i.e., acceptability) of driving under the influence of alcohol (DUI-A) and cannabis (DUI-C), and riding with a driver under the influence of alcohol (RWI-A) and cannabis (RWI-C) in Washington State young adults., Methods: Participants included 1,941 young adults from the 2019 cohort of the Washington Young Adult Health Survey. Weighted logistic regressions assessed the associations between peer injunctive norms and impaired driving-related behaviors., Results: A weighted total of 11.5% reported DUI-A, 12.4% DUI-C, 10.9% RWI-A, and 20.9% RWI-C at least once in the past 30 days. Overlap between the outcomes was observed, indicating some young adults had engaged in multiple impaired driving-related behaviors. After controlling for substance use frequency, weighted logistic regressions indicated more positive perceived injunctive norms were associated with nearly 2 ½ times higher odds of DUI-A, 8 times higher odds of DUI-C, 4 times higher odds of RWI-A and six and a half times higher odds of RWI-C., Discussion: Results increase the understanding of how injunctive norms-a potentially malleable psychosocial factor-are associated with four impaired driving-related outcomes. Prevention programs that focus on assessing and addressing the norms of these outcomes individually and collectively, such as normative feedback interventions and media campaigns, may be helpful in reducing these behaviors., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: Experiencing negative substance use consequences may deter future use, alter patterns of substance use (e.g., substituting one substance for another, combining substances), or point to a sustained pattern of engaging in heavy or frequent use. We used monthly data to examine relationships between negative alcohol and cannabis use consequences experienced in one month and changes in use the following month., Method: Data were from 508 individuals (59% female; ages 18-23 years at enrollment) who were surveyed monthly for 2 years and used both alcohol and cannabis during the study period. Multilevel models assessed within-person associations between monthly fluctuations in substance-related negative consequences and the next month's substance use (i.e., typical drinks per week, cannabis use frequency, and simultaneous alcohol and cannabis/marijuana [SAM] use), controlling for the prior month's substance use., Results: Positive associations were found between alcohol consequences and the following month's alcohol use and between cannabis consequences and subsequent cannabis use, although only the cannabis association was statistically significant. There was little evidence of effects of cannabis consequences on the next month's alcohol use or alcohol consequences on the next month's cannabis use. Cannabis consequences had a positive and statistically significant association with the next month's SAM use. Within-substance positive associations were strongest for physical alcohol consequences and cannabis consequences of low motivation, memory problems, and trouble breathing., Conclusions: Experiencing negative cannabis use consequences predicted more frequent cannabis use and greater chance of SAM use 1 month later. Results point to negative consequences, along with prior use, indicating risk for future use.

We examined patterns of longitudinal trajectories of loneliness during the COVID-19 pandemic using six time points (January 2020 [pre-pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most-likely loneliness trajectory adjusting for pre-pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre-pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past-month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co-occurring loneliness and cannabis use are needed., (© 2023 Society for Research on Adolescence.)

Prior research suggests that higher trait negative emotion differentiation (NED; one's ability to make subtle distinctions between different negative emotional states) is associated with consuming less alcohol when experiencing high negative affect (NA) in daily life. Yet, whether these findings extend to cannabis use behaviors is unclear. The present study used intensive daily data to test whether NED moderated the relationship between NA and cannabis behaviors. A community sample of 409 young adults who used alcohol and cannabis completed a baseline survey and five 2-week bursts of online surveys across two years. Multilevel models tested cross-level interactions between trait NED (person-level) and daily NA (daily-level) predicting cannabis use, hours high, negative consequences, craving, and coping motives. In contrast to expectations, on days with higher reported NA, people with higher NED (compared to those with lower NED) had a greater likelihood of experiencing any cannabis craving, experienced more intense craving, and reported higher cannabis coping motives. NED x NA interaction was not significant for likelihood of cannabis use, hours high, or negative consequences. Post-hoc descriptive analyses suggest notable person-specific heterogeneity in these findings. Individuals with higher ability to differentiate between negative emotions reported higher coping motives and craving when experiencing higher NA. However, these associations were variable for individuals within the sample. It may be that high NED individuals crave and purposefully use cannabis to reduce NA states. Findings are inconsistent with the alcohol literature and have important implications for intervention efforts aimed at reducing coping-motivated cannabis use among young adults., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Little is known about the prospective relationship between cannabis use and pain reliever misuse. This study examined associations of non-medical and medical cannabis use with onset of non-medical pain reliever misuse among young adults in Washington State (WA), where non-medical cannabis is legal., Methods: Data were from a cohort-sequential study of adults 18-25 residing in WA. Four annual surveys were used from cohorts recruited in 2014, 2015, and 2016. Participants who had not reported non-medical pain reliever misuse at baseline were included in discrete time survival analyses (N = 4,236). Odds ratios (ORs) were estimated for new onset of non-medical pain reliever misuse in any given follow-up year over the course of three years according to baseline non-medical and medical cannabis use., Results: When included separately in models, non-medical and medical cannabis use at baseline were associated with increased risk of non-medical pain reliever misuse adjusting for demographic characteristics as well as past year cigarette use and alcohol use (non-medical OR = 5.27; 95 % CI: 3.28, 8.48; medical OR = 2.21; 95 % CI: 1.39, 3.52). Including both forms of use in the model, associations of non-medical and medical cannabis use with non-medical pain reliever misuse onset remained (non-medical OR = 4.64; 95 % CI: 2.88, 7.49; medical OR = 1.65; 95 % CI: 1.04, 2.62)., Conclusions: Despite claims that cannabis use may reduce opioid use and related harms, findings suggest that cannabis use, including medical use, may not be protective, but instead may increase risk for non-medical pain reliever misuse., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Since the start of the coronavirus pandemic, some U.S. adults have increased alcohol and cannabis use frequency to cope with distress. Among sexual minoritized young adults (SM YAs), coping-related use may be greater due to disproportionate negative social and financial consequences of the pandemic. Nonetheless, it remains unclear whether pandemic substance use has increased among SM YAs compared to non-SM YAs relative to prepandemic levels and whether heightened coping motives mediate these potential differences., Method: A total of 563 YAs (18-24 years at baseline; 31.0% SM) provided survey data collected across 12 bimonthly assessments. Six assessments were measured in 2015 or 2016 and six across the coronavirus pandemic (2020-2021). Controlling for prepandemic assessments matched by calendar month, latent structural equation models examined group differences in alcohol and cannabis frequency and consequences across the COVID-19 period and tested coping motives as mediators of these differences., Results: Substance use and consequences were similar during the pandemic relative to prepandemic levels across groups. Nonetheless, compared to non-SM individuals, SM participants reported greater cannabis frequency, consequences, and cannabis coping motives during the pandemic independent of prepandemic levels. Cannabis use and consequences were each explained largely by coping motives during the pandemic among SM compared to non-SM YAs. These patterns were not found for alcohol outcomes., Conclusions: The COVID-19 pandemic has widened cannabis disparities between SM and non-SM YAs, due in part to pandemic-related increases in coping motives. Responsive public policy is needed that may prevent and remit SM cannabis disparities during societal crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adverse life events that threaten normative transitions are associated with increased alcohol and cannabis use among young adults. However, few studies have tested the extent to which specific negative events impact substance use behaviors nor identified relevant risk or protective factors (e.g., perceived control). During the COVID-19 pandemic, young adults experienced economic adversities (i.e., job loss and financial strain) at disproportionally high rates. This provided a unique opportunity to test associations between job loss/financial difficulties and substance use outcomes and whether perceived control in work and finance domains moderated these associations. Young adults completed self-report surveys at two time points-prior to the COVID-19 pandemic (January 2020) and in the acute phase of the pandemic (April/May 2020). Participants (N = 519; M age  = 25.4 years; 62.8% female) were recruited in and around Seattle, WA, as part of an ongoing longitudinal cohort study. Pandemic-related job loss (18.9%) and financial difficulty (49.7%) were relatively common in this sample. Job loss was associated with increased number of drinks on the heaviest past-month drinking occasion (from January 2020 to April/May 2020). Financial difficulty was associated with increased drinking frequency and number of drinks on the heaviest drinking occasion. The effect of job loss and financial difficulty on alcohol and cannabis use was generally moderated by participants' perceived control of these domains. For those with low perceived control, job loss/financial difficulty was associated with increased alcohol/cannabis use, but for those high in perceived control, job loss/financial difficulty was associated with decreased alcohol use frequency. Findings give advance understanding of how economic adversities relate to young adults' alcohol and cannabis use. Notably, perceived control over these domains may be modifiable through prevention efforts aiming to foster self-efficacy among young people and policy to provide available agency to those in need., (© 2023. Society for Prevention Research.)

Background: Simultaneous alcohol and cannabis use (SAM) is associated with riskier drinking. However, little is known regarding mechanisms of risk during drinking episodes. The current study tested whether subjective responses to simultaneous vs. alcohol-only use (i.e., high arousal positive/reward, high arousal negative/aggression, low arousal positive/relaxation, low arousal negative/impairment) were mechanisms through which SAM use was associated with daily drinking., Methods: Emerging adults who co-use alcohol and cannabis (N=85) completed 21 days of ecological momentary assessment with drink-contingent reports during drinking episodes. Participants reported on their simultaneous use and current subjective effects during drink reports and past-night total drinks consumed and negative consequences experienced the next morning. Three-level multilevel models (momentary, daily, person level) tested whether SAM use predicted subjective responses, and whether subjective responses mediated associations between SAM use, heavier drinking and negative consequences., Results: At the momentary and day-level, SAM (vs. alcohol-only) use predicted increased high arousal positive/rewarding, low arousal positive/relaxing, and low arousal negative/impairing subjective effects. SAM use indirectly predicted heavier day-level drinking and further negative consequences through high arousal positive/rewarding response. SAM use also indirectly predicted day-level negative consequences through low arousal negative/impairing response. At the person-level, more frequent SAM use predicted higher person-average high arousal positive/rewarding and low arousal positive/relaxing responses, and high arousal positive/rewarding response mediated relation between SAM frequency and heavier drinking., Conclusions: Simultaneous use was associated with reward, relief, and impairment, and reward and impairment were mechanisms of risk between SAM use and riskier drinking. Findings may inform theory and just-in-time interventions seeking to reduce alcohol misuse., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: There has been concern regarding increased substance use during the COVID-19 pandemic, particularly among young adults, but much of this concern stemmed from cross-sectional or short-term data collected early in the pandemic. This study followed a young adult community cohort throughout the first 1.5 years of the pandemic to examine longer-term trends/trajectories in alcohol and cannabis use behaviors., Method: Beginning before the COVID-19 pandemic (January 2020), 656 young adults completed up to eight surveys on substance use and other behaviors, which extended through August 2021. Multilevel spline growth models estimated changes in alcohol/cannabis use in three segments: (a) from pre-pandemic to April 2020, (b) from April 2020 to September/October 2020, and (c) from September/October 2020 to July/August 2021. Abstainers were removed from the analyses, yielding subsamples for alcohol models ( n = 545; M age = 25.6 years; 59.8% female) and cannabis models ( n = 303; M age = 25.6; 61.4% female)., Results: Drinking frequency initially increased (3% per month), decreased in the second segment (4% per month), and plateaued in the final segment. Drinking quantity significantly decreased in all three segments: 4% per month in segment one, 3% per month in segment two, and 1% per month in the final segment. Cannabis frequency and quantity showed no significant changes across the first two segments, then significantly decreased in the final segment (3% and 6% per month, respectively). The significant changes for cannabis frequency/quantity were moderated by age, such that older participants had steeper decreases in the final segment., Conclusions: Findings highlight that young adult alcohol and cannabis use generally declined across the first 1.5 years of the COVID-19 pandemic, contrary to widespread concerns., Competing Interests: The authors have no conflicts of interest to disclose.

Background: Given recent historical increases in young adults frequent cannabis use and changes in cannabis policies throughout the United States, there is a need to examine high-risk patterns of use. This paper examined predictors and cannabis-related outcomes of "wake-and-bake" cannabis use, operationalized as use within 30min of waking., Methods: Participants were 409 young adults (M age =21.61 years, 50.8% female) enrolled in a longitudinal study on simultaneous alcohol and cannabis use (i.e., using alcohol and cannabis at the same time such that their effects overlap). Eligibility criteria included reporting alcohol use 3+ times and simultaneous alcohol and cannabis use 1+ times in the past month. Participants completed twice-daily surveys for six 14-day bursts across two calendar years. Aims were tested using multilevel models., Results: Analyses were limited to cannabis use days (9406 days; 33.3% of all sampled days), and thereby to participants who reported using cannabis (384 participants; 93.9% of the sample). Wake-and-bake use was reported on 11.2% of cannabis use days and at least once by 35.4% of participants who used cannabis. On wake-and-bake use days, participants were high for more hours and had greater odds of driving under the influence of cannabis, but did not experience more negative consequences, relative to non-wake-and-bake cannabis use days. Participants who reported more cannabis use disorder symptoms and those reporting higher average social anxiety motives for cannabis use reported more frequent wake-and-bake use., Conclusions: Wake-and-bake cannabis use may be a useful marker of high-risk cannabis use, including driving under the influence of cannabis., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: Using substances to cope with social anxiety is robustly related to negative consequences. The present study uses daily-level methods to test whether days young adults used substances to cope with social anxiety were associated with greater alcohol and cannabis use and consequences compared to use days without this motive., Method: Participants were a community sample of young adults enrolled in a study on alcohol and cannabis use, which involved a baseline survey and five 2-week bursts of online daily surveys across 2 years. Aims were tested using multilevel models among a subsample of 257 participants who reported social anxiety coping motives 1 day or more during the study period; M age = 21.8 ( SD age = 2.2), 51% female; 49% non-Hispanic/Latinx White., Results: Compared to use days without social anxiety coping motives, days with social anxiety coping motives were associated with more drinks consumed and more positive and negative alcohol consequences on alcohol-only days, more negative cannabis consequences on cannabis-only days, and heavier use, more negative cannabis consequences, and more positive consequences for both substances on co-use days. Days with social anxiety coping motives were associated with a greater likelihood of positive item-level consequences (e.g., "was more sociable") on drinking days. Baseline social anxiety symptoms did not moderate associations., Conclusions: Days young adults used substances to cope with social anxiety were high-risk days for elevated substance use and consequences, regardless of baseline social anxiety. Positive consequences attained through drinking to cope with social anxiety may be an important pathway that reinforces coping motivated use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Simultaneous alcohol and marijuana (SAM) use is reported to be associated with heavier alcohol and marijuana use and more negative consequences, but less is known about the social, physical, and temporal contexts of SAM use., Method: Young adults ( N = 326, 51.2% male, 49.1% White non-Hispanic) who reported past-month SAM use completed up to 14 daily surveys across five bursts that assessed SAM use and negative consequences and social, physical, and temporal contexts. We used multilevel models to examine SAM use contexts' associations with alcohol/marijuana quantity and consequences., Results: The social context of alone only (vs. with others only) was associated with consuming fewer drinks. Physical contexts that included using both at home and outside the home (vs. only at home) were associated with greater alcohol and marijuana quantity and negative consequences (but not after controlling for alcohol quantity); use outside the home only (vs. only at home) was associated with more alcohol use, more alcohol consequences (but not after controlling for alcohol quantity), and fewer marijuana consequences (even after controlling for marijuana quantity). The temporal context of first engaging in SAM use before 6 P.M. (vs. after 9 P.M.) was associated with greater alcohol and marijuana quantity and more marijuana consequences (but not after controlling for number of hours high), and first engaging in SAM use between 6 and 9 P.M. was associated with more hours high., Conclusions: SAM use contexts such as using with others, using outside the home, and using earlier in the evening are typically associated with greater alcohol/marijuana quantity and consequences.

Sexual minority women and gender diverse (SMWGD) individuals are at elevated risk for alcohol and cannabis use disorders compared with cisgender, heterosexual women. This has been attributed to the unique stressors that SMWGD experience (i.e., sexual minority stress); however, recent studies have found mixed evidence for a link between sexual minority stress and substance use. The current manuscript introduces and tests a novel theoretical model derived from integrating minority stress theory and the multistage model of drug addiction to explain these mixed findings. We used data from a 30-day ecological momentary assessment (EMA) study of substance use among SMWGD to determine whether event-level associations between enacted stigma (bias from others) and same-/next-day alcohol and cannabis use are dependent on an individual's typical pattern of substance use (e.g., frequency, quantity, motives, and substance use disorder [SUD] symptoms). Findings indicate that enacted stigma predicted an increased likelihood of alcohol and cannabis use among those who used frequently and those who had a probable alcohol or cannabis use disorder and predicted a decreased likelihood of use among those who used less frequently. Enacted stigma also predicted cannabis (but not alcohol) use among those who reported high coping motives for use. Findings provide initial evidence in support of an integrated model of minority stress theory and the multistage model of drug addiction. Findings suggest that alcohol and cannabis use disorder interventions for SMWGD would benefit from addressing sexual minority stress and coping skill-building. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Planned and unplanned substance use have been examined as predictors of heavier alcohol and cannabis use and problems at the between-person level. However, it remains unclear whether planned versus unplanned use is riskiest at the day-level, and for whom. The present study tested whether day-level planned versus unplanned alcohol and cannabis use were associated with higher alcohol and cannabis consumption and negative consequences that day and whether two impulsive traits, lack of premeditation and positive urgency, moderated associations., Method: Young adults ( N = 409; 50.9% female) completed five bursts of daily surveys, each consisting of a morning and afternoon report across 14 consecutive days. During a baseline session, participants reported their impulsivity (UPPS-P). During afternoon surveys, participants reported their plans to use alcohol/cannabis that night. During morning surveys, participants reported number of drinks consumed/hours spent high yesterday and negative consequences experienced., Results: Planned drinking days were associated with a greater number of drinks and negative consequences, whereas planned cannabis use days were associated with more hours spent high but not negative consequences. In the drinking quantity model, there was a significant interaction for planned versus unplanned drinking by positive urgency. Planned drinking was associated with heavier alcohol consumption across levels of positive urgency; however, unplanned drinking was associated with heavier consumption for individuals with higher (vs. lower) levels of positive urgency., Conclusions: Day-level planned drinking and cannabis use are important factors to target in just-in-time interventions. However, interventions focused on planned and unplanned drinking may be particularly effective for individuals with higher levels of positive urgency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Purpose: Young adults may use alcohol and cannabis as sleep aids, a risky behavior that can worsen sleep health over time and lead to substance dependence. Perceived norms for such risky behaviors are often overestimated and related to one's own use. This cross-sectional study examined: (a) the extent to which college students overestimated the prevalence of alcohol and cannabis use as sleep aids (i.e., perceived descriptive norms), and (b) the extent to which perceived descriptive norms were associated with students' own use of alcohol and cannabis as sleep aids., Methods: 2,642 undergraduate college students ( M age  =  18.84 years) reported past 30-day use of alcohol and cannabis as sleep aids. Participants also estimated the percent of college students who use alcohol and cannabis as sleep aids (i.e., perceived descriptive norms)., Results: One-sample t -tests revealed participants, on average, overestimated the norms for using alcohol and cannabis as sleep aids. Participants who endorsed past 30-day use of these substances as sleep aids overestimated these norms to an even greater extent. Count regression models showed perceived descriptive norms were associated with students' use of alcohol and of cannabis as sleeps aids, in respective models, even when controlling for sleep difficulties., Conclusions: College students may overestimate the prevalence of using alcohol and cannabis as sleep aids, and students who believe these behaviors are more normative report more frequent use of these substances as sleep aids. Taken together, findings may highlight the potential for norm-correcting strategies as a prudent approach to reducing/preventing the use of alcohol and cannabis as sleep aids.

Objective: Alcohol use among college students during 21st birthday celebrations constitutes a well-known example of event-specific drinking when alcohol use is both pervasive and heavy. Less is known about how 21st birthday alcohol use compares to other birthday celebrations during young adulthood, whether similar increases occur for cannabis use on 21st birthdays, and whether the "21st birthday effect" is similar for noncollege young adults. Alcohol and cannabis use during 19th to 25th birthday celebrations were explored among college and noncollege students., Method: Participants were 720 young adults of ages 18 to 23 (M = 21.1, SD = 1.7) at enrollment who completed 24 monthly surveys, and 204 reported on a 21st birthday. Participants resided in a state where cannabis was legal and were asked the month following their birthday whether they engaged in alcohol and cannabis use as part of their birthday celebration., Results: Multilevel models found a 21st birthday effect for alcohol use as individuals consumed over twice as many drinks on their 21st birthday than would have been expected given age trends in birthday drinking, and this effect held for college and noncollege students. A 21st birthday effect for cannabis was not found., Conclusions: 21st birthday celebrations represent a high-risk drinking event for young adults in general, and the current findings suggest event-specific prevention programs targeting all young adults turning 21 are warranted. Unlike alcohol where turning 21 is associated with socially and culturally normative use, a similar 21st birthday effect was not found for cannabis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Measuring marijuana use quantity in survey research is complicated due to wide variation in the types (e.g., flower, edibles) and potency of marijuana products and in the modes (e.g., smoking, dabbing) used to consume products. There is currently no gold standard marijuana use quantity measure for survey research. This study examined whether number of hours high can be used as a proxy for marijuana use quantity in survey research, particularly in intensive longitudinal designs., Methods: Participants came from a community sample of young adults participating in a longitudinal study on simultaneous alcohol and marijuana use that used a longitudinal measurement-burst design in which participants completed surveys on up to 14 consecutive days in up to five bursts across nearly two calendar years. Those who reported using marijuana on at least one sampled day were included in present analyses (N = 379; M age = 21.6; 50.7 % female). Hypotheses were tested using Poisson multilevel models and a logistic regression., Results: Within persons, mode-specific marijuana use quantity variables predicted same-day number of hours high indicating evidence of initial criterion validity. In turn, hours high predicted same-day negative marijuana-related consequences indicating evidence of proximal predictive validity. Between persons, participants' average number of hours high was positively associated with their odds of possible cannabis use disorder following the last burst demonstrating distal predictive validity., Conclusions: Number of hours high may be a parsimonious proxy for measuring marijuana use quantity (regardless of mode of use) in survey research, particularly in intensive longitudinal designs., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Motor vehicle crashes remain a leading cause of death among young adults (ages 18-25) in the United States. Many drivers implicated in these crashes are under the influence of alcohol, cannabis, or the simultaneous use of alcohol and cannabis. Extremely limited research has assessed impaired driving behaviors and their predictors at the daily level. Perceived norms and motives to use substances have empirical support suggesting they may impact impaired driving-related behavior. Novel approaches to assess these associations at the daily level are needed and may inform future intervention and prevention programs., Objective: The goal of the current study is to utilize electronic daily assessments to assess driving under the influence of alcohol, cannabis, or simultaneous use and riding with a driver impaired by these substances to assess variability and predictors of these impaired driving-related behaviors at the daily level. This present manuscript details a protocol, measures, and a plan of analyses to assess how within-person differences in perceived norms and motives to use are associated with the likelihood of engaging in impaired driving-related behaviors., Methods: Participants include young adults in Washington State who report simultaneous use in the past month and either driving under the influence of alcohol, cannabis, or simultaneous use, or riding with a driver under the influence of both substances in the past 6 months. Individuals who verify their identity and meet eligibility requirements will complete a baseline assessment after which they will be scheduled for training on the daily assessment procedure via Zoom. Next, they will be invited to complete daily surveys on Thursday, Friday, Saturday, and Sunday every other week for 6 months and a 6-month follow up assessment. Analyses will utilize multilevel models with days nested within individuals., Results: The study is currently recruiting participants. A total of 192 participants have been recruited and 100 have completed the study protocol. Data collection is expected to be completed in Fall 2022., Conclusions: This study utilizes a novel design to assess impaired driving and predictors at the daily level among young adults at high risk of impaired driving-related behaviors. Findings will provide unique data that will shape the knowledge base in the field of social science and public health substance use research and that may be helpful for future prevention and intervention efforts on impaired driving., Competing Interests: The authors have declared that no competing interests exist.

Study Objectives: To examine the effects of sleep duration on next-day alcohol and cannabis craving and use among young adults., Method: A community sample of young adults who reported recent simultaneous alcohol and cannabis use at screening (N = 409; M age  = 21.61; 50.9% female) completed twice daily surveys (morning and afternoon) for five 14-day sampling bursts (i.e., 70 days total). Daily measurements included sleep duration, alcohol and cannabis craving, and alcohol and cannabis use (i.e., number of drinks, hours high). Multilevel models enabled examining associations between sleep duration and substance use/craving at three distinct levels: daily-level, burst-level, and person-level., Results: At the day-level, sleep duration was inversely associated with craving for both alcohol and cannabis: Stronger craving was reported on mornings and afternoons after relatively shorter sleep duration. At the burst-level, sleep duration was inversely associated with morning and afternoon alcohol craving indicating stronger alcohol craving, but not cannabis craving, during two-week periods when young adults have accumulated shorter sleep duration. Pertaining to alcohol and cannabis use, no daily-level effects were found, but the burst-level effect showed that participants engaged in greater alcohol use during two-week bursts with shorter sleep duration., Conclusions: Based on a non-clinical sample of young adults reporting substance use, results suggest shorter sleep duration may be a modifiable risk factor as it pertains to substance use and cravings. Results highlight day-level effects of shorter sleep duration on substance use cravings and adverse effects of cumulative sleep deficit on alcohol use., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: The present study examined daily associations between mental health symptoms (i.e., depression and anxiety symptoms) and simultaneous alcohol and marijuana (SAM) use and use-related negative consequences among young adults., Method: Participants were a community sample of 409 young adults between the ages of 18-25 who drank alcohol at least three times in the past month and reported SAM use in the past month ( M age = 21.6, 50.9% female). A baseline assessment included a measure of SAM use motives, after which participants completed five 14-day bursts reporting daily mental health symptoms and alcohol/marijuana use., Results: Daily mental health symptoms were not associated with SAM use likelihood. However, baseline SAM coping motives moderated the association between mental health symptoms and use such that young adults with stronger coping motives showed a stronger positive association between mental health symptoms and SAM use. Further, on SAM use days, reporting more mental health symptoms relative to one's average was associated with experiencing more use-related negative consequences, even after controlling for daily levels of alcohol and marijuana use (RR = 1.03, 95% CI = 1.01-1.05, p = .002)., Conclusions: The association between daily mental health symptoms and SAM use depended on whether the young adults had coping motives for use. Daily fluctuations in mental health were associated with negative use-related consequences experienced on SAM use days regardless of motives. These findings highlight the potential importance of prevention and intervention strategies particularly on days when young adults are experiencing increased mental health symptoms. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Alcohol and marijuana are commonly used by young adults, and use of both substances, particularly at the same time, is prevalent among this population. Understanding the prevalence, patterns, correlates, and consequences of simultaneous alcohol and marijuana (SAM) use is important to inform interventions. However, this literature is complicated by myriad terms used to describe SAM use, including use with overlapping effects and same-day co-use., Objectives: This scoping review identifies and describes the peer-reviewed literature focused on SAM use by young adults and distinguishes simultaneous use from same-day co-use of alcohol and marijuana. This review also provides a narrative summary of the prevalence of SAM use, patterns of SAM and other substance use, psychosocial correlates, and consequences of SAM use., Eligibility Criteria: This review is limited to papers written in English and published in peer-reviewed journals between January 2000 and August 2021. It includes papers assessing simultaneous use or same-day co-use of alcohol and marijuana among young adults ages 18 to 30. Review papers, qualitative interviews, experimental lab studies, policy work, toxicology or medical reports, and papers focused on neurological outcomes are excluded., Sources of Evidence: PubMed, PsycINFO, and Web of Science databases were searched. Databases were selected and the search strategy developed in consultation with an information specialist., Charting Methods: A data charting form was utilized to specify which information would be extracted from included papers. Eight categories of data were extracted: (1) research questions and hypotheses; (2) sample characteristics; (3) study procedures; (4) definition of SAM use; (5) prevalence of SAM use; (6) patterns of SAM and other substance use; (7) psychosocial correlates of SAM use; and (8) consequences of SAM use., Results: A total of 1,282 papers were identified through initial search terms. Through double-blind title/abstract screening and full-text review, the review was narrowed to 74 papers that met review inclusion criteria. Review of these papers demonstrated that SAM use was prevalent among young adults, particularly among those who reported heavier quantities and more frequent use of alcohol and marijuana. Enhancement-related motives for use were consistently positively associated with SAM use. SAM use was associated with greater perceived positive and negative consequences of alcohol and/or marijuana use. Inconsistencies in prevalence, patterns, correlates, and consequences were found between studies, which may be due to large variations in measurement of SAM use, populations studied, methodological design (e.g., cross-sectional vs. intensive longitudinal), and the covariates included in models., Conclusions: The literature on simultaneous use and same-day co-use of alcohol and marijuana has expanded rapidly. Of the 74 included papers (61 on SAM use; 13 on same-day co-use), 60 papers (47 on SAM use; 13 on same-day co-use) were published within the last 5 years. Future research focusing on the ways in which SAM use confers acute risk, above and beyond the risks associated with separate consumption of alcohol and marijuana, is needed for understanding potential targets for intervention., Competing Interests: Disclosures The authors declare no competing financial or nonfinancial interests.

Objective: Alcohol use motives may characterize types of drinking that have unique associations with cannabis use and illuminate psychological processes underlying cannabis use. This study examined how alcohol use motives, both on average across two years and in a particular month, were associated with any and frequent cannabis use. Method: A young adult community sample (n = 486; 54% female, age 18-23 at enrollment) who used alcohol and cannabis in the year prior to study enrollment provided two years of monthly data. Multilevel logistic regression models predicting any and frequent (10+ occasions) past-month cannabis use estimated both between- and within-person effects of alcohol use motives, controlling for frequency of alcohol use and demographic covariates. Results: Alcohol use frequency was positively associated with any cannabis use at the between- and within-person levels and frequent cannabis use at the within-person level. Across two years, individuals who had higher average coping drinking motives and lower average social and conformity drinking motives were more likely to use cannabis frequently. Further, between-person variation in social motives was negatively associated with any cannabis use. Within-person, months with greater enhancement and social motives were associated with higher probability of any cannabis use. Conclusions: Using alcohol for coping reasons, rather than other-focused social reasons, indicated greater risk for frequent cannabis use, although drinking for social and enhancement reasons in a particular month signaled slightly increased short-term probability of any cannabis use. Assessment of alcohol motives may help guide targeting and timing of prevention related to cannabis use.

Study Objectives: Simultaneous alcohol and marijuana (SAM) use is increasingly prevalent among young adults but has adverse health consequences. The current study examined daily-level associations between perceived sleep health and SAM use, relative to non-substance-use days and alcohol- or marijuana-only days. We also estimated linear associations between alcohol/marijuana use and perceived sleep health and explored whether effects were moderated by combined use of alcohol and marijuana., Methods: A community sample of SAM-using young adults (N = 409; Mage = 21.61, SD = 2.17; 50.9% female; 48.2% White; 48.9% college students) completed twice-daily surveys for five 14-day sampling bursts. Daily measurements assessed substance use and perceived sleep health in terms of subjective sleep quality, negative impact of sleep on functioning, and symptoms of insomnia., Results: Multilevel models indicated that, relative to non-substance-use days, participants reported poorer perceived sleep health on alcohol-only days, better perceived sleep health on marijuana-only days, and mixed evidence regarding SAM use (i.e. fewer perceived symptoms of insomnia, but poorer perceived next day functioning attributed to sleep). Daily-level estimates showed increased alcohol use was associated with poorer perceived sleep health, while stronger effects from marijuana were associated with better perceived sleep health. Across all indices of sleep health, only one linear association was moderated by combined use: The adverse association between alcohol and next day functioning was weaker on days alcohol was combined with marijuana., Conclusions: Findings provide additional evidence for daily-level effects of alcohol and marijuana use on perceived sleep health and address an important literature gap regarding potential adverse effects of SAM use., (© Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: The current study expands the literature on simultaneous alcohol and marijuana (SAM) use by focusing on the distinction between unplanned and planned SAM use to identify potential intervention targets. This study explored whether unplanned or planned SAM use was associated with differences in alcohol and/or marijuana use and consequences. Method: A community sample of young adults (aged 18-25) with recent alcohol and SAM use was recruited [ N = 409; mean ( SD ) = 21.61 (2.17) years; 50.9% female; 48.2% non-Hispanic/Latinx White]. Participants completed five 2-week bursts of online daily surveys (2 ×/day; 81.99% of morning and 82.23% of afternoon surveys completed) and reported on substance use intentions and behavior. Results: Descriptive findings showed that among days on which participants reported SAM use, 41.85% of the days were unplanned SAM use days. Based on daily-level results from multilevel models, on days with unplanned SAM use, young adults reported consuming fewer drinks, fewer hours high from marijuana, and lower subjective intoxication/high, compared to planned SAM use days, thus indicating that planned SAM use was riskier. Unplanned SAM use was not significantly associated with positive or negative consequences related to alcohol or marijuana, after accounting for the number of drinks or hours high from marijuana. Conclusions: Current findings suggest that interventions should target days on which young adults are planning to engage in SAM use. Future work is needed to identify factors that predict planned SAM use on specific occasions and also to disentangle the potential role of unplanned heavy use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background: Young adults who engage in simultaneous alcohol and marijuana (SAM) use may be more likely to engage in unsafe behaviors including riding with impaired drivers and driving after alcohol and/or marijuana use., Methods: Young adult SAM users (N = 408) self-reported their behavior for five 14-day bursts, yielding daily-level responses on a total of 14,675 substance use days. Adjusted odds ratios (AOR) estimated the likelihood of riding with an impaired driver and of driving after use on SAM use days compared to alcohol- or marijuana-only use days., Results: More frequent SAM users were more likely to ride with an impaired driver and to drive after use than less frequent SAM users (between-persons). On SAM use days, there were greater odds of riding with an impaired driver, compared to alcohol-only days (AOR = 1.28) and marijuana-only days (AOR = 2.22), and of driving after use, compared to marijuana-only days (AOR = 1.25). Driving after use was more likely on days with non-simultaneous alcohol and marijuana use compared to SAM use (AOR = 1.59)., Conclusions: Riding with an impaired driver is common among young adult substance users, and more likely following simultaneous use of alcohol and marijuana compared to other types of alcohol and marijuana use. Driving after use is more likely after SAM use than marijuana-only use days, but most likely on days when both alcohol and marijuana were used but not simultaneously. Future research on situation-level predictors of riding and driving-related risks among young adults is warranted., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Measures assessing marijuana-related consequences or problems experienced by young adults have typically been adapted from measures assessing alcohol consequences. These measures may not fully reflect the specific unwanted or perceived "not so good" effects of marijuana that are experienced by young adults. Thus, using these measures may present a gap, which needs to be addressed, given that reports of consequences are often utilized in brief motivational personalized feedback interventions. Data from three different studies of young adults were used to (1) examine self-reported "not so good" effects or consequences of marijuana use among frequent marijuana-using college students (Study 1), (2) create a new version of a marijuana consequences list and compare it to an existing marijuana consequences measure (Study 2), and (3) assess convergent and divergent validity between a finalized Marijuana Consequences Checklist (MCC, 26-items) and marijuana use and risk for cannabis use disorder (Study 3). The most frequently endorsed self-reported effects of marijuana included the impact on eating (the "munchies"), dry mouth, trouble concentrating, and acting foolish or goofy. Higher scores on the MCC were associated with more frequent use and a higher probability of meeting criteria for cannabis use disorder. The MCC represents a range of negative consequences of marijuana use derived from frequent users' own accounts and includes consequences not assessed by other measures. The MCC captures marijuana-specific negative consequences relevant for young adults, which can be incorporated in brief motivational personalized feedback interventions., (© 2020. Society for Prevention Research.)

Young adult frequent cannabis use has increased in prevalence and some frequent users have problems reducing their use. A strong link between momentary craving and subsequent use behaviors among individuals with problematic cannabis use has been reported in the literature, including young adults. In treatment contexts, interventions based on associative learning and reinforcement aim to reduce the prevalence of problematic substance use by altering the association between craving and use by increasing craving management skills such as mindfulness and reducing unhelpful responding such as avoidance or suppression. However, this model has not been tested among young adult cannabis users. The current study examined the influence of trait and state craving management strategies (mindfulness, coping style, experiential avoidance, and craving beliefs) on the link between momentary craving and use, using ecological momentary assessment in a sample of young adults with problematic use interested in reducing their use. Results demonstrated that two craving management constructs were associated with use: non-reactivity (p = 0.02) and non-judgment (p < 0.01). Interactions with momentary craving were observed for two constructs: non-judgmentalness (p = 0.02) and craving beliefs (p < 0.01). Findings suggest that treatments that increase non-reactivity and non-judgmentalness may reduce the occurrence of cannabis use for young adults contemplating reduction during an important period of biopsychosocial development by mitigating the impact of craving or directly reducing use. Additionally, negative beliefs about craving may serve a protective function during acute periods of elevation in momentary craving, an unexpected finding deserving further investigation., (Published by Elsevier Ltd.)

Background: Cannabis is purported to alleviate symptoms related to cancer treatment, although the patterns of use among cancer patients are not well known. This study was designed to determine the prevalence and methods of use among cancer patients, the perceived benefits, and the sources of information in a state with legalized cannabis., Methods: A cross-sectional, anonymous survey of adult cancer patients was performed at a National Cancer Institute-designated cancer center in Washington State. Random urine samples for tetrahydrocannabinol provided survey validation., Results: Nine hundred twenty-six of 2737 eligible patients (34%) completed the survey, and the median age was 58 years (interquartile range [IQR], 46-66 years). Most had a strong interest in learning about cannabis during treatment (6 on a 1-10 scale; IQR, 3-10) and wanted information from cancer providers (677 of 911 [74%]). Previous use was common (607 of 926 [66%]); 24% (222 of 926) used cannabis in the last year, and 21% (192 of 926) used cannabis in the last month. Random urine samples found similar percentages of users who reported weekly use (27 of 193 [14%] vs 164 of 926 [18%]). Active users inhaled (153 of 220 [70%]) or consumed edibles (154 of 220 [70%]); 89 (40%) used both modalities. Cannabis was used primarily for physical (165 of 219 [75%]) and neuropsychiatric symptoms (139 of 219 [63%]). Legalization significantly increased the likelihood of use in more than half of the respondents., Conclusions: This study of cancer patients in a state with legalized cannabis found high rates of active use across broad subgroups, and legalization was reported to be important in patients' decision to use. Cancer patients desire but are not receiving information about cannabis use during their treatment from oncology providers. Cancer 2017;123:4488-97. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made., (© 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.)

Background: An important life‐course event with respect to alcohol and cannabis use is turning 21 years of age, which may be associated with increases in use of these substances due to celebrations during the month and easier access to them on and following this birthday. We examined the trajectories of alcohol and cannabis use behaviors in the months leading up to, during, and following the 21st birthday month. We also examined whether the use trajectories vary by college status and baseline levels of use. Methods: We used data from 203 young adults recruited from the Greater Seattle region who turned 21 during the course of the study. Surveys were administered each month for 24 consecutive months. Measures included the typical number of drinks per week for the past month, the frequency of heavy episodic drinking, the number of cannabis use days, and any simultaneous alcohol and cannabis use. Multilevel spline models were run that estimated linear slopes over time at four intervals: (1) up to 1 month before the 21st birthday month; (2) from 1 month before to the month of the 21st birthday; (3) from the 21st birthday month to 1 month following; and (4) from 1 month following the 21st birthday month through all following months. Results: Alcohol use, generally, and simultaneous alcohol and cannabis use showed sharp increases from the month before the 21st birthday month to the 21st birthday month and decreases following the 21st birthday month. For cannabis use, there were significant increases in the months leading up to the 21st birthday and no other significant changes during other time intervals. Patterns differed by baseline substance use and college status. Conclusions: Findings from the current study have implications for the timing and personalization of prevention and intervention efforts. Event‐specific 21st birthday interventions may benefit from incorporating content targeting specific hazardous drinking behaviors in the month prior to the 21st birthday. [ABSTRACT FROM AUTHOR]

We examined patterns of longitudinal trajectories of loneliness during the COVID‐19 pandemic using six time points (January 2020 [pre‐pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most‐likely loneliness trajectory adjusting for pre‐pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre‐pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past‐month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co‐occurring loneliness and cannabis use are needed. [ABSTRACT FROM AUTHOR]

Background: The contexts in which young adults drink alcohol play a salient role in alcohol‐related outcomes and negative consequences at an event‐level, but less is known about longitudinal risks. We collected longitudinal monthly data across 2 years on (a) daytime drinking, (b) pregaming/pre‐partying, and (c) playing drinking games. We then examined associations between drinking in these contexts and within‐person variability in alcohol consumption, consequences, and simultaneous alcohol and marijuana (SAM) use in a given month. We also examined the extent to which drinking in these contexts predicted hazardous drinking (using Alcohol Use Disorders Identification Test (AUDIT) scores) at a distal follow‐up timepoint, controlling for baseline AUDIT scores. Method: A community sample of 759 young adults (Mage = 21.1 years; 56.4% female) completed monthly surveys for 24 consecutive months and a distal 30‐month follow‐up. Multilevel models estimated within‐ and between‐person associations between drinking context frequencies (daytime drinking, pregaming, drinking games) and alcohol‐related outcomes (weekly consumption, consequences, SAM use). A single‐level negative binomial regression tested associations between drinking context frequency averages across a two‐year period and changes in AUDIT scores from baseline to a follow‐up 2.5 years later. Results: Over 75% of the sample of non‐abstaining young adults reported drinking in each of the three contexts at least once during the 24‐month period. Within‐persons, young adults reported greater consumption, more negative consequences, and increased likelihood of SAM use during months that they drank in these contexts more often than usual. Each context was associated with negative consequences, even when controlling for alcohol use frequency. More frequent daytime drinking and pregaming, but not drinking games, were associated with increases in AUDIT scores at the 30‐month follow‐up, suggesting that there are potential long‐term risks of drinking in these contexts. Conclusions: Findings suggest that daytime drinking, pregaming, and playing drinking games are high‐risk contexts in terms of month‐to‐month and long‐term risks. Additional research is needed on the various contexts in which young adults drink alcohol and the extent to which contextual factors interact with one another to amplify/reduce risks and harms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Alcohol and marijuana are commonly used by young adults, and use of both substances, particularly at the same time, is prevalent among this population. Understanding the prevalence, patterns, correlates, and consequences of simultaneous alcohol and marijuana (SAM) use is important to inform interventions. However, this literature is complicated by myriad terms used to describe SAM use, including use with overlapping effects and same-day co-use. OBJECTIVES: This scoping review identifies and describes the peer-reviewed literature focused on SAM use by young adults and distinguishes simultaneous use from same-day co-use of alcohol and marijuana. This review also provides a narrative summary of the prevalence of SAM use, patterns of SAM and other substance use, psychosocial correlates, and consequences of SAM use. ELIGIBILITY CRITERIA: This review is limited to papers written in English and published in peer-reviewed journals between January 2000 and August 2021. It includes papers assessing simultaneous use or same-day co-use of alcohol and marijuana among young adults ages 18 to 30. Review papers, qualitative interviews, experimental lab studies, policy work, toxicology or medical reports, and papers focused on neurological outcomes are excluded. SOURCES OF EVIDENCE: PubMed, PsycINFO, and Web of Science databases were searched. Databases were selected and the search strategy developed in consultation with an information specialist. CHARTING METHODS: A data charting form was utilized to specify which information would be extracted from included papers. Eight categories of data were extracted: (1) research questions and hypotheses; (2) sample characteristics; (3) study procedures; (4) definition of SAM use; (5) prevalence of SAM use; (6) patterns of SAM and other substance use; (7) psychosocial correlates of SAM use; and (8) consequences of SAM use. RESULTS: A total of 1,282 papers were identified through initial search terms. Through double-blind title/ abstract screening and full-text review, the review was narrowed to 74 papers that met review inclusion criteria. Review of these papers demonstrated that SAM use was prevalent among young adults, particularly among those who reported heavier quantities and more frequent use of alcohol and marijuana. Enhancement-related motives for use were consistently positively associated with SAM use. SAM use was associated with greater perceived positive and negative consequences of alcohol and/or marijuana use. Inconsistencies in prevalence, patterns, correlates, and consequences were found between studies, which may be due to large variations in measurement of SAM use, populations studied, methodological design (e.g., cross-sectional vs. intensive longitudinal), and the covariates included in models. CONCLUSIONS: The literature on simultaneous use and same-day co-use of alcohol and marijuana has expanded rapidly. Of the 74 included papers (61 on SAM use; 13 on same-day co-use), 60 papers (47 on SAM use; 13 on same-day co-use) were published within the last 5 years. Future research focusing on the ways in which SAM use confers acute risk, above and beyond the risks associated with separate consumption of alcohol and marijuana, is needed for understanding potential targets for intervention. [ABSTRACT FROM AUTHOR]

Alongside the SARS-CoV-2 virus, the COVID-19 pandemic is associated with several secondary health effects. There is concern for increased substance use motivated by coping with stress, anxiety, depression, and boredom–all of which may be elevated during the pandemic. The current study examined intraindividual changes (from pre-COVID to during COVID) in young adults' alcohol and marijuana use, perceptions of peers' use (i.e., norms), and motives for use. A community sample of young adults (N = 572; M age = 25.14; 60.8% women) was recruited in Washington State. By using a repeated-measures design, data were collected prior to the COVID-19 pandemic (January 2020) and again during the initial acute phase of the pandemic (April/May of 2020). Young adults, on average, increased alcohol use frequency but decreased the amount consumed per drinking occasion. No changes in marijuana use were identified. Young adults (on average) perceived that peers had increased the frequency and total amount of alcohol use and perceived that peers were engaging in heavier marijuana use than prior to COVID-19. For alcohol use motives, there was a significant increase in depression coping motives and significant decreases in social, enhancement, and conformity motives. Boredom motives for marijuana use significantly increased, while celebration motives decreased. Using a prospective design with a sample initially recruited in Washington State, these data indicate that (a) young adults' patterns of alcohol use may have changed, (b) young adults tend to think that peers are engaging in heavier alcohol/marijuana use than before the pandemic, and (c) motives for using alcohol/marijuana may have changed during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Alcohol and marijuana are the most commonly used substances among adolescents but little is known about patterns of co-use.Objectives: This study examined patterns of concurrent (not overlapping) and simultaneous (overlapping) use of alcohol and marijuana among adolescents.Methods: Data from US-national samples of 12th graders (N = 84,805, 48.4% female) who participated in the Monitoring the Future study from 1976 to 2016 and who used alcohol and/or marijuana in the past 12 months were used to identify latent classes of alcohol use, marijuana use, and simultaneous alcohol and marijuana (SAM) use.Results: A four-class solution indicated four patterns of use among adolescents: (1) Simultaneous alcohol and marijuana (SAM) use with binge drinking and recent marijuana use (SAM-Heavier Use; 11.2%); (2) SAM use without binge drinking and with recent marijuana use (SAM-Lighter Use; 21.6%); (3) Marijuana use and alcohol use but no SAM use (Concurrent Use; 10.7%); and (4) Alcohol use but no marijuana or SAM use (Alcohol-Only Use; 56.4%). Membership in either SAM use class was associated with a higher likelihood of truancy, evenings out, and use of illicit drugs other than marijuana. SAM-Heavier Use, compared to SAM-Lighter Use, class members were more likely to report these behaviors and be male, and less likely to have college plans.Conclusions: Among 12th graders who use both alcohol and marijuana, the majority use simultaneously, although not all use heavily. Given the recognized increased public health risks associated with simultaneous use, adolescent prevention programming should include focus on particular risks of simultaneous use. [ABSTRACT FROM AUTHOR]

Background Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in 4 states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol. Methods The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and nonmedical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic Search Premier, Econlit, Legal Collection, Medline, PsycARTICLES, and Psyc INFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined. Results The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States. Conclusions Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Furthermore, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the margin of alcohol use examined. Design of policy evaluation research requires careful consideration of these issues. [ABSTRACT FROM AUTHOR]

• We examined IPA among individuals who reported SAM, CAM, and alcohol use only. • Alcohol and marijuana co-use, not pattern of use, was related to increased IPA. • SAM and CAM use were associated with more IPA perpetration than alcohol use alone. • IPA perpetration did not differ between those who reported SAM versus CAM use. Alcohol and marijuana are two of the most widely used substances in the U.S, with rates of alcohol and marijuana co-use increasing in recent years. Despite this increase, little is known about the effects of alcohol and marijuana co-use patterns (e.g., simultaneous, concurrent) on intimate partner aggression (IPA) perpetration. The purpose of the current study was to examine differences in IPA among simultaneous and concurrent alcohol and marijuana use groups and an alcohol-only group. Participants were 496 individuals (57% identifying as a woman) recruited nationally in April 2020 via Qualtrics Research Services who reported being in a current relationship and recently consuming alcohol. Individuals completed an online survey that included demographics, measures of COVID-19 stress, alcohol and marijuana use, and physical and psychological IPA perpetration. Based on survey responses, individuals were categorized as belonging to the alcohol use only group (n = 300), the concurrent alcohol and marijuana use group (n = 129), or the regular simultaneous alcohol and marijuana use group (n = 67). Due to inclusion criteria, there was no marijuana use only group. Individuals with regular simultaneous or concurrent alcohol and marijuana co-use reported more frequent physical and psychological IPA perpetration compared to those who only used alcohol. Neither physical nor psychological IPA perpetration frequency differed between individuals who reported regular simultaneous versus concurrent alcohol and marijuana co-use. Results suggest that alcohol and marijuana co-use in general, and not the specific pattern of use, is associated with an increased likelihood of IPA perpetration. [ABSTRACT FROM AUTHOR]

Background: Many young adults engage in simultaneous alcohol and marijuana (SAM) use so that their effects overlap. Little is known about motivations for dual substance use and associations with use and consequences. This study examined daily-level associations between cross-fading motives and levels of alcohol and marijuana use and consequences.Methods: Young adults who reported SAM use in the month prior were surveyed in two 14-day bursts. Data included 1049 SAM use days from 281 young adults (age 18-25; M age = 21.80, SD = 2.16; 50 % women). Multilevel models assessed between- and within-person effects of cross-fading motives (i.e., to enhance the effects of marijuana and/or alcohol use by using them simultaneously) on alcohol and marijuana use and consequences, after adjusting for general enhancement, social, coping, and conformity motives and the amount of alcohol and marijuana used that day.Results: On 76 % of SAM use days, participants endorsed cross-fading motives (i.e., to enhance the effect of alcohol or marijuana or to get drunk and high at the same time). Having stronger cross-fading motives was associated with greater alcohol use, perceived intoxication, and positive alcohol consequences at the between- and within-person levels. In addition, between-person, individuals who reported stronger cross-fading motives on average reported more negative alcohol consequences and positive marijuana consequences on average. Cross-fading motives on a given day were not associated with marijuana use or marijuana consequences that day.Conclusions: Cross-fading motives were common and varied from day to day. Understanding the motivational context for dual substance use may support future interventions for cross-fading. [ABSTRACT FROM AUTHOR]